Single and double versus intensive phototherapy in term newborns with severe hyperbilirubinemia

Background: Hyperbilirubinemia is one of the most common problems in term newborns and the phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. The purpose of this study is to compare the effectiveness of conventional phototherapy, double phototherapy and intensive phototherapy in decreasing serum bilirubin. Methods: This interventional study was done on 60 neonates divided randomly in three groups. Infants in group 1 received conventional phototherapy, in group 2 double phototherapy and in group 3 intensive phototherapy. The criteria for inclusion in the study were a weight >2500 gr and serum bilirubin level ≥18 mg/dl. Serum bilirubin level, rectal temperature and specific gravity of urine were evaluated 6 and 12 hours after phototherapy. The data were analyzed with SPSS and Anova soft wares.
Findings: The mean total bilirubin level of single, double and intensive phototherapy groups at the beginning of therapy were 19.7±1.6, 20.3±2.4 and 21.1±2.0 mg/dl respectively, there was no significant difference between the values. After 12 hours of therapy the mean total bilirubin levels of single, double and intensive phototherapy group were 18.0±2.2, 15.7±2.3 and 16.8±2.5 mg/dl respectively. Serum bilirubin concentration decreased during phototherapy (p=0.000) and there were significant differences between three groups (p>0.014). Body temperature increased in double phototherapy group (p=0.001), but it was stable in other groups. There was no significant difference between the groups (p=0.6). And no significant difference of the mean value of urine specific gravity in the three groups was observed after 12 hours of phototherapy.
Conclusion: Our study showed that intensive phototherapy is more effective than single and safer than double phototherapy in reduction of bilirubin in jaundiced newborns.